PUBLIC HOSPITAL DISTRICTS - THEIR PURPOSE, FORMATION, MAINTENANCE, AND DISSOLUTION

Revised May 2009

A. CHAPTER OUTLINE

B. CHAPTER SUMMARY

C. SPECIAL PURPOSE DISTRICTS, GENERALLY

• Special Purpose Districts Defined
• Powers And Limitations

D. BASIC PRINCIPLES BEHIND PUBLIC HOSPITAL DISTRICTS

• Overview Of Public Hospital Districts And Their Purpose
• Powers v. Duties, Generally
• Sources Of Public Hospital Districts’ Power
  • The Revised Code Of Washington (RCW)
  • State Constitution
  • Case Law And Attorney General Opinions
  • Other Statutes And Regulations
• Public Hospital District Location And Boundaries
• How District Hospitals Compare To And Differ From Non-Profit Hospitals

E. HOW TO SET UP A DISTRICT: FORMATION

• Introduction
• Forming A County-Wide Public Hospital District
  • Initiation By The County Legislative Authority
  • Initiation By The Citizens: The Petition Process
  • Proposition And Election
• Forming An Intra-County Public Hospital District
  • Maintenance Of Voting District And Precinct District Boundaries
  • No Initiation By County Board Of Commissioners
  • Initiation By The Citizens: The Petition Process
  • The Hearing Process
  • Opportunity To Change/Fix Boundaries Of Proposed District Before Citizen Vote
  • Post-Hearing Proposition And Election
• Forming An Inter-County Public Hospital District
  • Maintenance Of Voting District And Precinct District Boundaries
  • No Initiation By The County Board Of Commissioners
  • Initiation By The Citizens: The Petition Process
  • The Hearing Process
  • Opportunity To Change/Fix Boundaries of Proposed District Before Citizen Vote
  • Post-Hearing Proposition And Election

F. FARM UNITS AND PUBLIC HOSPITAL DISTRICT BOUNDARIES

G. STEPS TAKEN UPON THE FORMATION OF A PUBLIC HOSPITAL DISTRICT

• Section Summary
• Legal Steps
  • Rules Governing The Transaction Of District Business (Bylaws)
  • Establishing And Electing Offices Of The Board Of Commissioners
  • Determining The Number Of Commissioners
  • Adopt An Official Seal
  • Adopt A Resolution Providing For Their Compensation
  • Make A Survey Of Existing Health Care Facilities And Services
  • Adopt A Plan Of Improvements
  • Adopt A Budget
  • Appoint A Superintendent
  • Designate A District Auditor

H. MANAGEMENT OF A DISTRICT: OVERVIEW AND OPTIONS

I. COMMISSIONER DISTRICTS

• Introduction To Commissioner Districts
• Creation Of Public Hospital Commissioner Districts
• Abolishing/Reestablishing Public Hospital Commissioner Districts

J. HOW TO EXPAND A DISTRICT: ANNEXATION OF TERRITORY

• Section Summary
• When No Qualified Electors Reside In The Territory Or All Electors Sign The Petition For Annexation
  • Guiding Principles
  • Petition By Property Owners
  • Public Hearing
  • Resolution
  • Annexation By Resolution
• When Qualified Electors Reside In The Territory And Not All Electors Sign The Petition For Annexation
  • Guiding Principles
  • Resolution Calling For An Election
  • Public Hearing
  • Post-Hearing Special Election
  • Assessment Of Debt

K. HOW TO EXPAND A PUBLIC HOSPITAL DISTRICT: REANNEXATION

• Section Summary
• Procedural Steps
• The Resolutions Process
• The Referendum Process

L. HOW TO EXPAND A DISTRICT: CONSOLIDATION

M. HOW TO SHRINK A PUBLIC HOSPITAL DISTRICT: WITHDRAWAL OF TERRITORY

• Section Summary
• The Resolutions Process
• Withdrawal Of Territory And Property Taxes

N. HOW TO SHRINK A PUBLIC HOSPITAL DISTRICT: DIVISION

• Section Summary
• Procedural Steps
  • Determination Of Public Interest
  • Division Plan
  • Pass A Resolution
  • Petition To Court
  • Court Hearing
  • Election
  • Creation Of New Commissioner Districts And Positions
• Creation Of A New District Or Districts Upon Division

O. HOW TO DISSOLVE A DISTRICT

• Section Summary
• Procedural Steps
  • Petition
  • Hearing
  • Order Of Dissolution
  • If Solvent: Sale Of Assets
• Insolvency Issues, Generally
  • Levy To Pay Deficit
  • Order Of Dissolution

P. OPERATING SERVICES OUTSIDE DISTRICT BOUNDARIES: EXTRA-TERRITORIAL OPERATIONS